to compare banding sleeve gastrectomy using silicone ring Versus using natural flap ( round ligament of the liver)

to compare banding sleeve gastrectomy using silicone ring Versus using natural flap ( round ligament of the liver) as regard weight loss, complications rat and cost

Inclusion Criteria:

• obese patients with BMI more than 40 with or without co-morbidity or more than 35 with co-morbidity
• patients fit for laparoscopic surgery
• give approval to share in the study

Exclusion Criteria:

• patients refused to share in the study
• patients unfit for surgery
• patients aged less than 18 and older than 65
• patient with previous upper abdominal surgery either for obesity or other diseases
• revisional bariatric procedures